Getting a pilot is hard. Going from that pilot to a full-scale implementation is even harder. With the abundance of new and promising technologies and solutions coming to bear in the digital health space, healthcare systems and organizations are becoming more refined in terms of what types of innovation they want to embrace. From the outlook of the entrepreneur, this means that not only does it remain difficult to get a first pilot, but also increasingly challenging to take that successful pilot to scale throughout a system.

Yet there are certain tried and true tactics and means to increase the likelihood of adoption.

First, have a great solution that solves an unmet need or greatly improves an inefficient and/or costly problem. Once that is in place, follow the steps below to set yourself up for success.

Start with the correct people from day 1
An error many entrepreneurs make is not finding the right person or persons who can help your technology go to scale in an organization. The person who can say “yes” to a pilot may not be the same person who can give the green light to full-scale implementation if the pilot goes well.

Nor may this just be one person.

Donovan Morrison, CEO of Luna Lights, a company that provides an automated lighting system that utilizes cloud-based data analytics to reduce the risk of falling for older adults, recommends focusing on C-level executives.

Persist, and with luck you can meet with the CEO, COO, CFO, or leader of the group in which your solution provides benefit. Entrepreneurs “need a buy-in from a group of individuals” at the top who can then connect you with the right people at the operational level, according to Morrison. He adds, “A warm intro is always best but don’t be afraid to cold call. Know the person’s name and be confident!”

Leveraging your network may also yield to meetings with C-suite executives.

If your company went through or was part of an incubator/accelerator, “use those platforms to facilitate strong introductions on your behalf,” advises Aloysius Fobi, MD, VP, Business Development for NurseGrid, an application that helps nurses manage their work schedule with ease. Keep this broader network in mind as you choose seed investors or accelerators and “make sure you vet them because that is a huge advantage” Fobi believes.

Create internal champions
After getting the attention and support of senior leadership, a crucial compounding success factor for adoption is garnering internal champions at the operational level.

There, the ideal internal champion is a leader from the group that derives the most benefit from your solution. These are the individuals whose satisfaction, productivity, and effectiveness are improved by your offering. They will be passing feedback, directly or indirectly, to the decision makers who will decide on full-scale implementation. These champions need to be your number-one customers and startups need to make sure they “receive the white-glove treatment”, says Fobi.

Provide these users with the highest quality service and let them know that you want feedback during the pilot. Fobi tells seeks feedback from customers because that is beneficial to both.

While the operational champion is invaluable in terms of product feedback, the C-level champion is the one who needs to be able to move the initiative forward in leadership meetings. If possible, try to get more than one person on the prospect’s leadership on board. By doing this, your solution becomes more defensible if the pilot comes into question during leadership discussions. By having a corroborating voice in the boardroom, it becomes easier to get support from the larger C-level leadership group.

Lastly, always be looking for your next internal champion. “Win-over as many decision makers as you can across multiple departments,” states Morrison. “You want multiple people in the corporate meetings and across the company to be proponents.”

Green lights and red flags
Before moving into specific strategies to increase the likelihood of a customer transition from a pilot to full implementation, startups need to first identify some specific green lights or red flags to make sure their solution is truly needed. Be sure you can answer “yes” to the following questions:

Has the organization identified the area that your solution impacts as an issue?

Is this issue a critical need for the organization?

Have you identified that end users truly feel this issue as a pain point?

Additionally, a startup should take the time to learn more about the target customer’s organization: What are their strategic priorities? What technology do they currently have in place and what might the costs to switch be? Also, make sure you know who in the organization has ownership of the current technology and what obstacles that may pose and make sure to be aware of what is on the customer’s roadmap.

Once the pilot begins, put in place the building blocks of full-scale implementation so that you are ready for enterprise-wide adoption in the pilot phase. You’ll have already sold the customer on the idea and benefits of your solution so the customer should already be thinking about next steps.

“Health systems might wait till the end of a pilot before looking at these metrics, so you want to be able to provide everything on a silver platter so they don’t have to do as much work,” Asai emphasizes.

Equally important is being able to show the value of your solution and the impact it has made on the customer’s organization.

“Point the customer toward a model of how other customers calculate an ROI so they don’t have to build the financial model from scratch,” says Asai.

Having a clear way for the customer to measure and calculate the benefit is critical, and even better if you can provide that for them with evidence that is validated by previous customers.

Early in the process, make sure you can speak the customer’s language and address their pains. Fobi recommends asking the customer, “assuming we succeed, what are the next steps?”

In this, also be sure to understand budget cycles and ask about the characteristics of previous successful pilots and take note of any specific insights. During the pilot, be mindful of your communications with the customer and make sure the customer has all the information they need for any decision well in advance of needing to make a decision. If you do begin to notice any disconnects in the communication flow, “be more proactive about reaching out and figuring out what the disconnect is.” advises Morrison.

“The person you are working with may be too busy to give you a lot of their time,” Morrison adds. “If enthusiasm has waned, set up time during the pilot to get people on board and then address any issues during the pilot to show marked improvement in the second half of the pilot.”

What to do if things begin to stall during the pilot
Not every pilot will be a monumental success. Therefore, in addition to the aforementioned tactics, there are a few actions you can take as a startup to get things back on track.

Fady Hawatmeh, CFO/COO of Third Eye Health, a company providing a secure, HIPAA-compliant system for exchanging medical information and conducting telemedicine from any device in real-time, advises proving your worth by showing your data. A major tactic is to “make clients realize, if they didn’t go beyond the pilot to full implementation, how big of a negative impact that would be on their business.”

Hawatmeh also encourages startups to “be ready for full implementation early in the pilot to show the hospital that you are ready and prepared and that you can execute right away, not that you’ll “figure it out post-pilot”.

"Another method that Asai uses at 3Derm is to continue to generate good news and progress and make sure that your internal advocates and champions get that good news and data. “Keep the conversation going and share your successes,” she says. Creating a positive atmosphere around the solutions and having the proof points that it works will make it an easy decision for senior leadership to say “yes” to moving to the next phase of implementation.

Not all pilots end up going through successful implementation, nor should they. As much as the experience should benefit the customer in their opportunity to pilot and demo your solution, it should equally be a pilot for the startup to make sure that this customer is a good fit.

But as one last piece of advice from Liz Asai, “always have a pipeline—but don’t forget to keep doors open; the priorities of a healthcare organization that said no initially may shift in future months and that system may want to reengage.” So be ready.